Part 4

This phenomenon must not be confused with the cases of rumination and regurgitation, which from time to time are recorded. The food in this case is not swallowed, nor does it pass any point from which it can be regurgitated. Eighty-one individuals of different nationalities and from several classes of society whom we have studied are now in conscious possession of their reflexes. These seem readily educated back to normal functions by all who seriously and patiently adopt the habit of what seems only at first to be excessive insalivation.

The dictum “bite your food well” that we so often use, has no meaning to those suffering from the results of mal-assimilation and mal-nutrition, especially should they have few or no teeth of their own. I make so bold as to state that dyspepsia _et morbi hujus generis omnis_ will cease to exist if patients be persuaded to bite their food until its original taste disappears, and it is carried away by involuntary deglutition.

The important point of the whole question seems to be this alkaline reduction of acid food before it passes on to meet subsequent digestive processes elsewhere, which then become alternately acid and alkaline.

In the first few months of infant life, when saliva is not secreted, Nature ordains that mammary secretion be alkaline. With the eruption of teeth come an abundant flow of saliva and a synchronous infantile capacity for managing other foods. This flow of saliva depends on a thorough demand and use to maintain its generous supply. It is just at this time that children learn to bolt their food,--the demand fails, with a consequent detriment to the salivary glands, digestive processes, and the system generally.

A, B, C, and D were placed on an absolute milk diet. A drank his milk in the ordinary way, and at the end of three days begged to discontinue the experiment owing to disgust at the monotony of the diet. B, C, and D continued the experiment for seventeen days, insalivating the milk, but to a varying extent, B the least and D the most. Though D took most milk, he excreted least solid egesta, C excreting less than B. Can one infer that increased insalivation of a non-starchy food insured its better digestion and assimilation? Each subject took as much milk only as his appetite demanded, D taking the most, which never exceeded two litres daily. The weights of the subjects after the usual sudden drop of the first three days remained remarkably even until the end of the experiment. B, C, and D all relished the diet, and it satisfied the requirements of their appetites, but they experienced an increasing monotony.

As long ago as the seventeenth century, before the transformation of matter into energy by the animal organism, known as Metabolism, was understood, the fact was recognised that by the lungs, kidneys, skin, and intestines, substances no longer useful to the organism were eliminated, the retention of which proved harmful. The nature of these substances was unknown, but it was noted that however much the food was increased the weight of the body remained the same. In other words, a state of complete nutritive equilibrium was maintained.

The following table contains the _résumé_ of two experiments in which a state of complete nutritive equilibrium was maintained by individuals of about the same weight, on widely different quantities of food similar in quality. The subjects of the experiments were a laboratory assistant of Dr. Snyder, of the U. S. Department of Agriculture, and the writer. The experiment of the former was made primarily to show the relative digestibility of the several articles of diet, potatoes, eggs, milk, and cream:

═════════════════════════╤══════════════════════════╤═══════════════ │ Dr. Snyder’s │ │ Experiment. │ Writer’s │ Published in │ Experiment. │ Bulletin 43 │ —————————————————————————┼————─—─—─—─—─—────—─—─—─—─┼─—─—─—───—─—─—─ Age of subject │ 22 years │ 30 years Duration of experiment │ 4⅓ days │ 5 days Number of meals │ 13 │ 10 Weight at beginning │ 62.5 kilos. │ 57.3 kilos. Weight at end │ 62.6 kilos. │ 57.5 kilos. Potatoes (daily average) │ 1587.6 grammes │ 159.4 grammes Eggs (daily average) │ 411.08 grammes │ 124.7 grammes Milk (daily average) │ 710 c.c. │ 710 c.c. Cream (daily average) │ 237 c.c. │ 237 c.c. Daily urine │ 1108 grammes │ 1098 grammes Daily fæces │ 204 grammes │ 18.9 grammes —————————————————————————┴————─—─—─—─—─—────—─—─—─—─┴─—─—─—───—─—─—─

The daily diet of Dr. Snyder’s subject consisted of three and one-half pounds of potatoes, eight eggs, a pint and a half of milk, and half a pint of cream. The writer’s diet of twelve ounces of solid food (like Luigi Cornaro) consisted of three eggs, the remainder of the twelve ounces in potatoes, and an equal quantity of similar liquid food to that taken by Dr. Snyder’s subject. The exercise of the laboratory assistant comprised his daily routine of laboratory work, while that of the writer consisted of six sets of tennis, or an hour and a half on horseback, with an hour to an hour and a half’s walk or climb daily, in addition to much reading and writing.

In each case complete nutritive equilibrium was maintained, although the author subsisted on three-seventeenths of the solid food taken by the other subject.

Again, cannot one infer that better assimilation and less waste resulted from the better preparation of the smaller quantity of food by insalivation? Surely, too, there must be less daily strain on the intestinal canal, and body generally, in getting rid of 18.9 grammes of inoffensive dry waste, than in getting rid of 204 grammes of humid, decomposing, and offensive matter.

“Considerable importance has been attached to the normal action of the bacteria in the intestines; and it has even been supposed that the presence of bacteria is essential to life. Such a view has recently been shown to be erroneous by an elaborate and painstaking research carried out by Nuttall and Thierfelder, who obtained ripe foetal guinea-pigs by means of Caesarean section carried out under strict antiseptic precautions. They introduced the animals immediately into an aseptic chamber through which a current of filtered air was aspirated, and fed them hourly on sterilised milk day and night for over eight days.

“The animals lived, and throve, and increased as much in weight as healthy normal animals subjected to a similar diet for the purpose of controlling the results. Microscopic examination at the end of the experiment showed that the alimentary canal contained no bacteria of any kind, nor could cultures of any kind be obtained from it.

“The same authors, in a subsequent paper, described the extension of their research to vegetable food. This was also digested in the absence of bacteria. Under such conditions cellulose was not attacked. Hence they consider that the chief function of this material is to give bulk and proper consistency to the food so as to suit the conditions of herbivorous digestion.” (Schäfer’s “Text-Book of Physiology,” vol i. p. 465.)

Now, inasmuch as bacterial digestion has no place in the animal economy, surely it can only occur at the expense of the organism?

Can micro-organic action take place in the intestines without the production of toxins and the consequent absorption of these toxins into the blood?

We know that the metabolism of a cell is determined by the general physical environment of the whole organism, by supplies of oxygen and water, on nervous impulses, and, what chiefly concerns this argument, on the nature and amount of the pabulum supplied to it. This pabulum is derived from the alimentary canal.

Are not even those of us who may be enjoying seemingly the best of health supplying to our tissues pabulum containing mild toxins, thus causing an increased katabolic action to occur in each individual cell of our bodies?

Are not the blood elements, floating in a plasma containing such toxins, rendered resistant, weaker, less capable of fulfilling their functions as carriers and combatants of disease?

Are not their and our lives, in consequence, more painful and shorter than they need be?

Would not the elimination of these toxins render us less liable to disease? And is not their presence an important element in predisposition to disease?

When this reflex is restored micro-organisms get no further than the stomach. They are destroyed there by the acid gastric juices, then only stimulated to their full and normal secretion by the presence of a sufficiency of alkaline substance. Undigested matter having been eliminated, micro-organisms, still existing in the intestines, deprived of their means of subsistence, decrease, and, in time, may cease to exist. The body no longer absorbs the toxins these produced. To this fact may be ascribed the increase of mental energy, the general physical betterment, the cessation of morbid cravings for food and drink and of those of a sexual nature, which are noticed and experienced.

What has just been stated is based not entirely on experimental evidence but somewhat upon inference. The inference seems justified because the excreta, more especially of the intestines, but also of the kidneys and skin, become almost odourless and entirely inoffensive. The solid egesta are voided thickly covered with mucus, leaving the end of the bowel dry and clean. The sense of cleanliness can only then be appreciated to the full, for it is internal as well external. _Flatus_ is no longer produced. The urine is inoffensive and seems to be materially changed in quality, as shown by chemical analysis. Uric acid, the chlorides, and, more markedly, aromatic sulphates are reduced in quantity.

Owing to deliberation in eating, necessitated by this new habit, satiety occurs on the ingestion of considerably less food. By carefully studying one’s self I believe it possible to cultivate an instinct which will regulate not only the quantity but the quality of food that the body may need, and that in the _normal health_ of a full-grown body, no more food either in quantity or quality should be supplied than suffices to supply diurnal waste. Any excess must result in pathological processes.

Although there results enhanced pleasure in the taking of all foods, rich and simple, and especially in the appreciation of good wines, the quantities of these foods and beverages that suffice to fully satisfy the appetite are much smaller than before, while there is a marked preference for the simpler kinds of food. The writer now can imagine no more pleasurable meal than one consisting of good brown bread, eggs, butter, cheese, and cream. These, with fresh vegetables and a very little fruit, form his staple diet. This tendency and preference for simple foods is the general experience among those who have recovered their reflexes of deglutition.

Following on the ingestion of a lessened quantity of food and on its better assimilation, there is less waste, the egesta are voided less frequently, sometimes only once in five to eight days.

The lower bowel is not the reservoir it formerly was. So hæmorrhoids cease from troubling and constipation cannot exist. For this same reason the body, at the beginning of the practice, commences to approximate to its normal weight, increasing or decreasing as the individual’s environment demands.

A few more words only need be said. It has been easy to state the results of experiments and observations: but the acquiring of this new reflex, while pursuing daily occupations, is not easy, and needs more than a little patience and much serious thought. The habits of a lifetime cannot be changed in a few days or weeks. The shortest time in which the reflex has been re-established is four weeks, and this only by avoiding conversation at meal-time and concentrating the attention on keeping the food in the mouth until complete alkaline reduction has taken place and sapidity has disappeared.

In closing I wish to maintain as a fact, gentlemen, of the truth of which you will only be convinced by actual experience, that by the restoration of this reflex and in complete dependence on its use, there lies true health, the establishment of a condition of stable nutrition and the possible abrogation of two great predisposing factors of disease, mal-assimilation and mal-nutrition. Unless there be among you, as in the “Cities of the Plain,” a parlous minority who possess this reflex and take your food as you ought, none of you are in the enjoyment of such health as you might have. A like punishment will be meted out to you as was visited on those cities, for you will all be consumed long before your day by the unnecessary combustion in your bodies caused by the circulation in them of toxins, the product of undigested and decomposing food.

The writer, bearing in mind the warning suggested by the Frenchman whose donkey died as soon as he had reduced his food to a single wisp of straw, finds that he is taking less and less food. While his mind is open as to his arriving at the final diet of Luigi Cornaro, yet it is easily conceivable that living a similar life of retirement in a placid environment, it would be quite possible to do as he did. Hence the title of this paper and the queries at the commencement.

The objects in publishing and distributing this paper are twofold: to make the subject as widely known as possible, and to solicit the aid of colleagues in investigating it more fully.

There is ready at the service of the general practitioner an important and potential therapeutic agent in the saliva of his patients and in the use _ad finem_ of their salivary digestions.

By any chance should readers of this paper wish to ask any questions, the writer will be happy to communicate with them.

183, CALLE DEL CAPELLO NERO, Piazza San Marco, Venice, Italy.

_Editor’s notes._ (1) Confirmatory evidence of the correctness of the deductions made in this paper has begun to come in from many professional sources and notably from a famous child specialist who avers that children would follow the natural requirements in eating were it not for artificial food, bad example, and bad teaching.

(2) In a report of a paper read before the _Société de Biologie_, Paris, France, March 15th, 1902, by M. Max Marckwald, of Kreuznach, “ON DIGESTION OF MILK IN THE STOMACH OF FULL-GROWN DOGS,” the following appears: “Hence these experiments confirm those of Horace Fletcher and Ernest H. Van Someren on the importance of prolonged mastication” (_translation_). Referring, as the latter statement does, to mastication (insalivation) of liquid, it gives an important suggestion relative to some probable causes of uncertain or defective digestion in human nutrition.

THE CAMBRIDGE TESTS

[In connection with a report of the Cambridge Examination the writer wishes to acknowledge the interest and assistance of Dr. Francis Gowland Hopkins, head of the Physiological-Chemical Department of the Physiological Laboratory of the University; Dr. George H. F. Nuttall, in charge of the Bacteriological Section of the Pathological Laboratory; Mr. Sidney W. Cole, Mr. Robert Barrett, and Dr. Hubert Higgins, both for practical work in the laboratory and in serving as test-subjects. To Dr. Higgins so much is due that it is difficult to measure. Since our first meeting in Cambridge, Dr. Higgins has been unremitting in his study of the subject and in consideration of its application to human betterment. Having the altruistic temperament inborn and not yet smothered by disappointment, the good doctor has consecrated himself to the service of poorer humanity, and his inspiration in so good a cause is wonderful motive power behind the native desire to do good. The statement of Dr. Higgins' experiences in pursuit of an Economic Nutrition is given in his own manner in the new edition of _Glutton or Epicure_, which is being published coincidently with this volume in the A. B. C. Life Series.

At the time we were in Cambridge, Dr. Hopkins and Mr. Cole had just published their paper in the _Journal of Physiology_ (English), describing their isolation of the tryptophane element of the proteid molecule which had eluded chemists from the beginning. In tryptophane they found embodied the odourous indol and skatol which appear so offensively in the putrid decomposition of proteid. In the excreta of the test-subjects in our Economic-Nutrition-Inquiry these malodorous substances did not appear, and hence another question is opened up to investigation relative to the putridity of human excrement under ordinary conditions of carelessness, and the absence of putridity in the case of nutrition accomplished by aid of thorough buccal treatment of food preparatory to digestion.

It is a matter of interest, relative to the patience required in science, to state that Dr. Hopkins and Mr. Cole were fourteen months searching for the fugitive tryptophane element after they received their first clew to its whereabouts. When isolated, tryptophane masses in a substance having the appearance of silver, but not the solidity of that metal.—HORACE FLETCHER.]

EXPERIMENTS UPON HUMAN NUTRITION

NOTE BY SIR MICHAEL FOSTER, K.C.B., M.P., F.R.S.

In 1901 Dr. Ernest Van Someren submitted to the British Medical Association, and afterwards to the Congress of Physiologists at Turin, an account of some experiments initiated by Mr. Horace Fletcher. These experiments went to show that the processes of bodily nutrition are very profoundly affected by the preliminary treatment of the food-stuffs in the mouth, and indicated that great advantages follow from the adoption of certain methods in eating. The essentials of these special methods, stated briefly and without regard to certain important theoretical considerations discussed by Dr. Van Someren, consist of a specially prolonged mastication which is necessarily associated with an insalivation of the food-stuffs much more thorough than is obtained with ordinary habits.

The results brought to light by the preliminary experimental trials went to show that such treatment of the food has a most important effect upon the economy of the body, involving, in the first place, a very notable reduction in the amount of food--and especially of proteid food--necessary to maintain complete efficiency.

In the second place this treatment produced, in the experience of its originators, an increase in the subjective and objective well-being of those who practise it, and, as they believe, in their power of resistance to the inroads of disease. These secondary effects may indeed be almost assumed as a corollary of the first mentioned; because there can be little doubt that the ingestion of food--and perhaps especially of proteid food--in excess of what is, under the best conditions, sufficient for maintenance and activity, can only be deleterious to the organism, clogging it with waste products which may at times be of a directly toxic nature.

In the autumn of 1901 Mr. Fletcher and Dr. Van Someren came to Cambridge with the intention of having the matter more closely inquired into, with the assistance of physiological experts. The matter evoked considerable interest in Cambridge, and observations were made not only upon those more immediately interested, but upon other individuals, some of whom were themselves medical men and trained observers.

Certain facts were established by these observations, which, however, are to be looked upon as still of a preliminary nature. The adoption of the habit of thorough insalivation of the food was found in a consensus of opinion to have an immediate and very striking effect upon appetite, making this more discriminating, and leading to the choice of a simple dietary, and in particular reducing the craving for flesh food. The appetite, too, is beyond all question fully satisfied with a dietary considerably less in amount than with ordinary habits is demanded.

Numerical data were obtained in several cases, but it is not proposed to deal with these in detail here, as they need the supplementary study which will be shortly referred to.

In two individuals who pushed the method to its limits it was found that complete bodily efficiency was maintained for some weeks upon a dietary which had a total energy value of less than one-half of that usually taken, and comprised little more than one-third of the proteid consumed by the average man.

It may be doubted if continued efficiency could be maintained with such low values as these, and very prolonged observations would be necessary to establish the facts. But all subjects of the experiments who applied the principles intelligently agreed in finding a very marked reduction in their needs, and experienced an increase in their sense of well-being and an increase in their working powers.

One fact, fully confirmed by the Cambridge observations, consists in the effect of the special habits described upon the waste products of the bowel. These are greatly reduced in amount, as might be expected; but they are also markedly changed in character, becoming odourless and inoffensive, and assuming a condition which suggests that the intestine is in a healthier and more aseptic condition than is the case under ordinary circumstances.

Although the experiments hitherto made are, as already stated, only preliminary in nature and limited in scope, they establish beyond all question that a full and careful study of the matter is urgently called for.

For this fuller study the Cambridge laboratories do not possess at present either the necessary equipment or the funds to provide it. For the detailed study of the physical efficiency of a man under varying conditions, elaborate and expensive apparatus is required; and the advantages claimed for the special treatment of the food just discussed can only be fully tested by prolonged and laborious experiments calling for a considerable staff of workers.

It is of great importance that the mind of the lay public should be disabused of the idea that medical science is possessed of final information concerning questions of nutrition. This is very far indeed from being the case. Human nutrition involves highly complex factors, and the scientific basis for our knowledge of the subject is but small; where questions of diet are concerned, medical teaching, no less than popular practice, is to a great extent based upon empiricism.

But the scientific and social importance of the question is clearly immense, and it is greatly to be desired that its study should be encouraged.

M. FOSTER.

April 26th, 1902.

REPORT OF A PLAN FOR THE INSTITUTION OF AN INTERNATIONAL INQUIRY INTO THE SUBJECT OF HUMAN NUTRITION

[Sir Michael Foster’s “Note” (preceding) and Professor Chittenden’s article in the _Popular Science Monthly_ (following), which form a part of this book, show a common want of exact knowledge relative to human nutrition not at all creditable to human intelligence at the beginning of the twentieth century; but they both offer hope of relief from this discreditable stigma in systematic study of the question. For this purpose an international inquiry was proposed, a plan was drawn up under advice of Sir Michael Foster, and the matter was given to the writer to promote by the best means available.

The Carnegie Institution seemed, at the time, the most likely supporter of such a scheme; but owing to an embarrassment of applications for support of American science needs, it was considered best not to attempt any foreign or even international benefaction, for the present at least, and hence other means of furthering the inquiry were sought.

The invitation of Professor Chittenden to repeat the demonstration of food-economy made by the author and Dr. Van Someren at Cambridge, England, of which Sir Michael Foster’s “Note” treats, at the laboratories of the Sheffield Scientific School of Yale University, led to the discovery that New Haven already possessed an equipment suitable for the inquiry much more complete than the plan Professor Foster had outlined as being desirable.